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Friday, 16 February 2018

The toughest week of our lives: part two

Like writing part one, it has taken me rather a while to get around to this post! Almost another month to be precise. That probably means I am not telling the story in its true form now; as they say, you quickly forget all the finite details... but here goes...

We went home the day after Pippa was born and after my cesarean (day 1). In hindsight this was far too early but I was a midwife and knew what I was doing so felt that I could be at home... I'd be doing the same things at home as I could in hospital right? After the cesarean she was very very mucoussy. Most section babies get mucoussy but she was possibly the worst baby I have ever seen. Because of this she wasn't really feeding very well and whenever she did feed she then vomited back up. Therefore I was trying her at the breast every 3hrs and then expressing and giving her that by syringe. The last good(ish) feed she had on the day we went home was about 7am. usually the wards wouldn't discharge someone when the feeding isn't great but like I said, I'm a midwife and knew the score/what to do etc. Also because I expressed so much antenatally I knew I had plenty of milf for her in the freezer, therefore when I was at home she was actually getting more milk than I was expressing for her in the hospital.

We were discharged at round 2pm and made our way to Jayne's house to pick up the dog on the way home. I was quite adamant that I wanted to introduce the both of them together at home. I didn't want to get Charlie back and the house already smell of this new weird creature. Again, with hindsight, this was our second mistake.

Initially is was nice being home and in my own environment but I soon got stressed about the feeding. It got to about 10pm and she still hadn't been to the breast since that morning and was still being really sick. In the end I rang the postnatal ward and spoke to a lovely, really experienced midwife who advised me to give her a 10ml top up with the intention to make her vomit the mucous out so then hopefully she would want to feed properly; so thats what I did.

1am came and so did the vomit. Loads of it. Darkly blood stained and it absolutely stank! Not normal what so ever!!!! I rang 111 who advised me that we should get her seen at the childrens hospital within an hour. Shit. Scott hadn't slept for god knows how long so was worried about him driving. I had managed to catch an hour just before the vomit happened but there was no way I could have driven.

Well this dilemma was taken out of our hands. I went to let the dog out for a wee before we left and Scott was changing Pippa's nappy when I hear this panicked call from upstairs. Rushing up, I find a very blue, not breathing baby on the changing table with loads more bloody vomit obstructing her nose and mouth. I instantly went into work mode and resuscitated her. At the time it felt like forever but it was probably no longer than a minute or so and she came round well. However because of this there was no way in hell I was putting her in the car and driving ourselves. I was NOT going to resus her again at the side of the road if it happened again. I rang 999 who agreed and sent us an ambulance.

On arrival of the ambulance crew she did her third bloodstained smelly vomit. They hadn't had any experience of such a young baby so I think they were thankful that I was a midwife. All we needed was the ride (and possibly to resus equipment if she went blue again). and they were happy for me to take the lead: fortunately it wasn't needed. When they saw the vomit though they did call ahead to the childrens as they were concerned about it too and they advised us to be blue lighted in. Luckily it was 2 in the morning by then so the roads were clear. I sat on the stretcher strapped in and held Pippa so she was upright. This worked well for me too as I was somewhat cushioned from the very bumpy journey, though to be fair at this point the last thing I was thinking about was myself.

When we got to the Childrens they did a full check on her which was fine and they weighed her too. This was a day earlier than it would usually be done (day 2 rather than day 3) and showed that she has lost 14% of her birth weight!!! Ouch! On day three we would expect babies to loose upto 10% of their birth weight so 14% really isn't good. Yet again, in hindsight it's not surprising as she vomited up more than she was getting in but at the time I felt like I had failed her. Luckily her blood tests showed that she wasn't too badly affected by the weight loss but did show that she had an infection. Because the blood she had vomited was old looking and not bright and fresh, it was believed that it was from me rather than her. They tested my breast milk but I knew it wasn't that as the blood in the vomit was way too much to be from me; specially when I was expressing and my milk was not obviously blood stained. Later on it was assumed that she probably ingested it at the cesarean and it festered in her which caused her infections. This explains why is was so heavily blood stained and why it smelt so bad.

After about 10hrs of observation, they wanted to admit her to the childrens hospital which would have meant I was staying as an outpatient... By this point it was lunchtime, I hadn't slept and had had minimal pain relief. I really needed to be an inpatient too. Unfortunately, once a baby is discharged post birth it is usual protocol to go to the childrens rather than back to the maternity unit which is hence why we ended up there. Because of this you usually then wouldn't get transferred back but I begged and luckily (probably because I am staff), Southmead did have us back.

As we were taken to the childrens by ambulance, our next issue was how to get from the centre of Bristol to Southmead. Luckily we have great friends who were so helpful. Jayne works in the centre so has a permit to park in all the streets. They drove both of their cars in, parked hers in a side street nearby and dropped the keys into Scott so we had transport. Luckily we had thought about the car seat when we left home the night before so had it with us.

We got back to Southmead at about 4pm by which point I felt like utter death, I cried all the way up the corridor to the ward, I was just so thankful to be back. Once we settled in they got the neonatal doctors there to review her, restested her bloods (including a septic screen) and reweighed her. They actually made her weight loss 12.7% so slightly better than at the childrens - probably the difference in scales and she had also had several formula feeds by this point which may also have helped. She started IV antibiotics and a feeding regime to get her back on track. This meant I was trying her at the breast every 3 hours, topping her up with as much formula as we could get in her and I was expressing and giving that too. I was so so thankful that one, I had a single room and two, that Scott could stay with me, I never would have managed it all on my own! I was pretty sleep deprived and emotional too so I don't think I would have coped with him having to leave me. He did pop home to meet Jayne to give her car back and to hand the dog back over to her. Poor Charlie had been on his own all day bar the neighbours popping in a couple times to let him out for a wee. If he hasn't freaked out enough by this new human in his house, he then suffered the stress we did in the middle of the night and then got left all on his own! I felt so awful for him! Luckily he loves staying with Jayne and her dogs so at least I knew he was happy there.

In the first 24 hours of being back in hospital (day 3) her weight went to 10.8%, a fantastic gain. It should have been though as she was absolutely pumped full of formula. So much so that its was impossible to get her to feed from me as she was so full all of the time. Therefore the next task was to get her to feed from me. As absolute luck would have it she got the message and literally woke up and decided to feed from me without much effort. She literally jumped on the boob. She still needed to feed 3 hourly but the plan was not to give her anymore formula providing she did feed. In the next 24hrs (day 4) her weight stayed the same. Although that doesn't sound good, they were happy with that as she had gone from having loads extra to just relying on me. However, in the next 24hrs (day 5) she had to gain else we would have to give her formula again. I hated giving her formula, she was sicky before but she was so so so much worse on the formula. It stinks too which meant she stank all the time. She spat it out a lot and got a rash on her chin. Luckily enough in she gained 30g taking the percentage to 10% exactly. This is considered a fine gain in such a short space of time. Each day she was also having her CRP checked and the same day it came back showing that the infection had resolved enough for her to stop the IV antibiotics.. this meant we could go home again!! These days had been the most stressful of our lives so leaving the hospital where I had 24/7 support was rather scary, specially after what happened the last time we went home. It felt like such a huge responsibility feeding her myself and the stakes were high because she had been so poorly. But we had to leave sometime right? So we did, and it was fine.

Although I knew full well about the baby blues, I never anticipated how bad they could be! Even when we were doing well at home I found myself randomly bursting into tears over absolute nothing. It went on longer than I thought too but then I guess it's such a huge adjustment both physically and mentally and I was being hard on myself. We didn't exactly have an easy start either!! But onwards and upwards, things did get better...

In the next installment I wish to natter on about how complicated the human overthinking brain can make breastfeeding and the wonders of the first few weeks as new parents! Now how long it will take me to get around to writing it, who knows!!

Saturday, 20 January 2018

The toughest week of our lives: part one

It's taken long time for me to have a chance to wrote these posts and it appears having a newborn means you have absolutely no time to yourself.

After my last post about reaching my due date, I ended up going more than a week overdue. We never wanted to commit to Christmas plans as we didn't know when this baby would arrive. I was convinced that if she didn't come early, then she would want to come on Christmas day. Well Christmas eve (5 days overdue) came and she was showing absolutely no signs of coming so we decided to go back to Devon for Christmas. This felt a little risky really but we packed all the hospital stuff just in case; at the end of the day it's still only just over an hour away if we needed to get back.

We were only home from Christmas eve morning until boxing day morning but the whole time I felt really very rotten. So much so that we came back early boxing day so I could see my midwife to get checked out. I wasn't really sleeping and getting myself pretty stressed, mainly worrying about my blood pressure. It's been on the higher side for a while and when at home I used Richards BP monitor to check it just out of interest. I don't think it was very accurate really as one reading was pretty high, the other completely normal, but this didn't do much good for my stress levels! Anyway, when back and at the midwife's, she confirmed that my blood pressure was high and sent me into hospital to get checked out.

Apologies for how awful I look! I was soo swollen!

When we got there it remained high but I didn't have any other symptoms of pre-eclampsia so they didn't medicate me but offered me induction. After a pretty long discussion with Scott we decided that induction was probably for the best. I had felt rubbish for ages and the blood pressure was most likely due to my stress so what was the point prolonging it any more? I had been niggling for ages and ages but labour was nowhere near.

So I had the propess and off to the ward I went to wait for things to happen. Scott went home to get some rest and sort the dog out and I got some kip. The propess was a pain in the arse, I was having so much mucoussy show that every time I got up, it came out!! This meant I ended up with loads of examinations before I was even doing anything.

By the morning I was tightening pretty regularly and when Scott came back in at 10am I was uncomfortable enough to need my TENS machine. At points I think it really helped but it was also annoying too, more of a distraction that actual pain relief but still, at least it seemed to be doing something. The last time the propess came out (about 8am) they said that they'd be able to break my waters so I went on the waiting list to go to delivery suite.

By about 2pm, I was contracting 4:10 lasting over 1min. GREAT! Getting there, hopefully...

At 3pm I was transferred to delivery suite and they broke my waters. Despite contracting already, there had been no change in my cervix. Up until this point although the contractions were painful, I was fully coping with them and felt in control of what was happening. As soon as my waters went I felt like I was dying. I cannot explain how horrendous it was. I felt like my whole pelvis was being ripped apart, the contractions were back to back and I was having no break to recover in between. I was only 1cm dilated so to begin with I refused to use the entonox... It was my first baby and I was only 1cm, I had a LONG LONG way to go and my experience as a midwife told me not to use it.... That last probably about 4 contractions and then I was puffing on it like my life depended on it. Unfortunately for me, it did absolutely nothing for the pain but just made me feel like I was VERY drunk and VERY out of control. I was screaming the place down which was particularly awful as I was in the room next to the staff room so all of my colleagues would have heard me making an absolute meal of it. I'm soo embarrassed. I knew I would swear, and I swore A LOT! After just a few minutes on the entonox I was begging for some pethidine which they gave me straight away, This seemed to space the contractions out a bit and relaxed me in between but when they did come they were still excruciating. So much so that I was begging for my epidural straight away, which again I got pretty much in record time, they didn't waste any time. Probably desperate to shut me up. The anesthetist (who I didn't know) was great but she did take two attempts at getting my epidural in and then I had quite a high block. I didn't care, it bloody worked and I was finally out of pain!

Not the way I intended on labouring..
Soon after my epidural went in they reexamined me. I can't remember the timings exactly but it couldn't have been much longer than about an hour from them breaking my waters; I had gone from 1cm to 4cm. Not bad!! Maybe thats why is was so excruciating?

3 hours later I was 4cm again, and they ascertained that baby was deflexed OP position (back to back with her head at the wrong angle) and I started the synto drip to make my contractions more effective. I was also pretty sore down below which my midwife put down to maybe a latex allergy from the catheter? I was really swollen and sore looking. I hadn't realised I was sensitive to latex before, you would have though I'd known as I use latex all the time when working. My hands often get dry and sore after working but I always put that down to washing them regularly at work, not because of the latex gloves.

Anyway, 3 hours after starting the drip, I had only progressed to 5cm. I was feeling pretty downhearted. Again being a midwife, seeing that little progress and having a baby in the position that mine was, I knew the outcome was looking pretty bleak. I was lucky enough to choose the midwife looking after me and we had a good talk about what it all meant. I was ready to give up and request a cesarean. She said to me that I had only been on the synto for 3 hours and that I should give it more of a chance. She said that if I was her daughter, her advice would be to carry on for another 3 hours to give myself as much chance as possible. So that's what we did.

3 more hours passed, and I was 5-6cm... So decision made, we went for a cesarean section. This was fine by me, I understood and wasn't really scared of theatre. Id been on the other side a million times so knew exactly what to expect. The only thing I was nervous about was knife to skin. As soon as that was done and I didn't feel it, I was fine. Scott, however, didn't like theatre at all. Not surprising I guess as he's never been in a situation like that in his life; and a very different experience than just me, him and the midwife in a room on our own.

Philippa Mary Ware
28th December 2017 @ 03:37am
7lb 13oz

Done. In no way the way we would have liked but I can't exactly say I'm surprised. I always had a feeling that things wouldn't be straightforward. But I don't mind, we have our beautiful baby girl. It's all worth it. Labour was horrendous and I can't imagine ever wishing to do it again but I am so thankful for the amazing care we received, we couldn't have asked for anything more. 

I'd like to say that all was well from now on but that wasn't the case, stay tuned for part two of our saga!

Tuesday, 19 December 2017

Due Date

So today's the day, the due date! I really thought I would have had a baby by now. I was soo convinced I could get her out early. Just goes to show doesn't it! I write this post right before going to bed with just an hour left of the 19th so its a pretty dead cert that shes not showing her face today! Grrr!!

Today, I went for a long walk around westonbirt with some work friends to see if that might encourage her... I have had a few tightenings but nothing exciting, only the same tightenings I've been getting for weeks. I think shes far too comfortable in there!

The texts and messages from everyone have already started "any news? Any signs? Had a baby yet??" That's going to get annoying very quick! Didn't think anyone really cared that much!

I really would like a baby before Christmas so that gives her another 5 days. Either that or wait until after boxing day, for babies sake More than anything. The lead up to Christmas is always exciting and fun, particularly when in school. However having a Christmas birthday is a bit rubbish as it's often over looked and I also think that the time between Christmas and new year is a bit depressing too!

I'm going trend up being induced on New years eve (term +12) aren't I!!!

Wish me luck!

Wednesday, 13 December 2017

I wanted to have a baby yesterday!


So I have finally caught up all of my posts and this is the first one written on time! the 12th was my Grandad's birthday so really would have loved my baby to have been born on his day. Since 37 weeks I have been chomping at the bit to have her but really felt fate might play its part in getting her here for this date. I think I made too much of the date as the night before I basically didn't sleep at all which wasn't a good start for hopefully going into labour!  Even yesterday evening I was still kind of hopeful as I had been tightening all day and my hormones were obviously flying as I had a couple of outbursts of tears for no reason at all. Today, I woke up and she was in a really awkward position and have had very few tightenings today. I'm still very tired too so I would be surprised if anything happened today. To be fair I am starting to resign myself that actually labour is really not that close at all right now!

I have tried a few things to get labour going. I have been drinking raspberry leaf tea - though probably not as regularly as I should be. I have brought myself an aromatherapy diffuser and have been pumping clary sage around the living room most days. A few months ago I brought myself a exercise/birthing ball (whatever you want to call it) as I get really uncomfortable in the evenings so I have been religiously bouncing up and down on that to try and get things going. The last thing I have been doing (which I have put most my hopes in working) is expressing. I have been leaking colostrum since about 19 weeks and nipple stimulation is meant to get your hormones going so I thought this would be a good thing to get on. To begin with I was only doing it ever other day. since 38 weeks I took to doing it daily and in the last few days I have been doing it twice a day. Maybe this is why I have been niggling so much? Though, not's not like labours actually started so who knows if any of this is doing anything! If nothing else, if this baby comes out and is a rubbish feeder, I have about 60mls colostrum frozen ready to feed her! I don't know why I am keeping it all really but I can't bring myself to waste it. We work so hard to express colostrum with women for their babies it doesn't seem logical in my brain to get rid of it!

Generally the last few weeks have been pretty boring and tiring so not the best few weeks of my life as I can't occupy myself with the things I would usually do. Despite this, up until this week I have stayed in good spirits but I have to say I am now starting to find it difficult to stay positive. I'm trying to find things to keep me occupied each day. My carpal tunnel is now in both hands and by far the most debilitating. At it's worst (like today) I have constant numbness and/or pins and needles in my fingers and everything I do I have to think about the positioning of my hands. One thing I have found that is both a time killer and not too painful on my hands is playing computer games. In the lounge, Scott has a computer set up with Steam and we sometimes play games using Xbox controllers. We recently played the Lego Harry Potter games and I have spent quite alot of time completing all the extra content. If I sit on my ball and use the controller, I am still moving my fingers to keep the circulation going but my wrists are at neutral positions which means I don't get too much pain. Now I've completed both games though I don't know what to play next!?

On Monday I decided to go shopping for some Christmas presents (we had done absolutely nothing up until this point). I managed to get everyone's all at once and wrapped them all too! They are not exactly thoughtful presents like I usually try to do but giving the circumstances I am just happy that I managed anything at all! We are pretty much all up together house wise so I hoped this might count as my nesting phase??

I know that life with a newborn is going to be pretty tough and I'll probably be even more exhausted than I am now but at least I will be occupied all of the time. It's all this sitting and waiting around which is killing me. Come on baby Ware we are so ready for you now!